Healthcare Provider Details

I. General information

NPI: 1477514966
Provider Name (Legal Business Name): INLAND PACIFIC IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 12TH AVE S
SEATTLE WA
98144-2712
US

IV. Provider business mailing address

1200 12TH AVE S
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-6500
  • Fax: 206-326-6501
Mailing address:
  • Phone: 206-326-6500
  • Fax: 206-326-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN WILSON
Title or Position: COO
Credential:
Phone: 509-747-4455